Effect of chemotherapy induced hair-loss on distress levels among cancer patients visiting public and private hospitals of Punjab

Abstract

Background: Chemotherapy is used as an important component of multimodal approach in the management of various malignancies the estimated incidence of chemotherapy-induced hair loss is 65%. Anagen effluvium is the most common form of hair loss associated with cancer therapy and is usually noticed within 1–2 weeks of starting the therapy and becomes more apparent in the next 4–8 weeks of therapy. However, it is documented in the literature that chemotherapy-induced hair loss can result in anxiety, depression, a negative body image, lowered self-esteem, and a reduced sense of wellbeing. Objectives: To determine the levels of chemotherapy induced alopecia on distress levels among cancer patients visiting public and private hospitals of Punjab. To find out the relationship between demographic variables and chemotherapy induced alopecia distress. Methodology: A cross sectional study was conducted in public and private hospitals of Punjab, over the duration of 6 months, from October 2021 to March 2022. A sample of 323 respondents with the age range 19-54 was obtained. Data collection tool was adapted version of chemotherapy-induced alopecia distress scale (CASD). It consisted of 25 items in five domains i.e. physical, emotional, daily activity, relationship and treatment. Results: High distress level was 61% (n=196) while low distress level was 39% (n=127). Majority of the sample population consisted of participants belonging to age group 18-34 (n=146, 45.2%). Most of them were male 53% (n=173).Half of the participants 50 %( n=161) taken from public hospital while remaining 50 %( n=161) were taken from private hospitals. Majority of participants (n=206, 63.8%) were living in rural areas. Respondents diagnosed at stage2 had low distress level (54%) as compare to respondents who were diagnosed at stage3 and stage 4. Significant association (p value ≤0.05) was found between Gender, family income, employment status, disease stage at diagnosis, number of chemotherapy cycles received and current active treatment. Conclusion: Chemotherapy-induced alopecia distress was associated with all of five domains i.e physical, emotional, daily activities, relationships and treatment. It is necessary to develop specific interventions to minimize distress due to alopecia for patients with cancer. Health professionals should also provide culturally appropriate education or interventions for self-care strategies related to alopecia and lowered body image as well as psychosocial support. Keywords: Chemotherapy induced hair- loss, Distress levels, Public and Private Hospitals, Punjab.